Heijtink R A, Smal P, ten Kate F J, Kruining J, Schalm S W
Department of Virology, Erasmus University Rotterdam, The Netherlands.
Antiviral Res. 1987 Jul;7(6):329-40. doi: 10.1016/0166-3542(87)90015-5.
We have characterized the hepatitis B virus state in liver and serum of 38 HBsAg-positive chronic hepatitis patients (chronic active hepatitis (CAH), 19; chronic persistent hepatitis (CPH), 7; cirrhosis, 11; 'normal' carrier, 1) and 21 HBsAg-negative patients. Episomal HBV-DNA in liver, without detectable integrated HBV-DNA sequences, concomitant with HBV-DNA in serum was found in 19 HBeAg-positive patients (CAH, 16; CPH, 1; cirrhosis, 2). Integrated sequences were detected in 13 HBsAg-positive HBeAg-negative patients (CAH, 1; CPH, 5; cirrhosis, 7) and in 1 HBsAg-negative patient. Episomal HBV-DNA and integrated HBV-DNA sequences were observed simultaneously in 1 HBsAg-positive HBeAg-negative CPH patient and in 4 HBsAg-positive cirrhosis patients (2 HBeAg-positive, 2 HBeAg-negative). The presence of HBcAg immunofluorescence corresponded well with that of episomal HBV-DNA. Antiviral therapy is advised for HBsAg-positive chronic hepatitis patients with episomal HBV-DNA, irrespective of the presence of integrated sequences. Since the presence of episomal HBV-DNA in liver is not always accompanied by the presence of serum HBV-DNA, procedures for the selection and evaluation of patients for antiviral therapy should be extended by characterization of the HBV-DNA state in liver biopsies.
我们已对38例HBsAg阳性慢性肝炎患者（慢性活动性肝炎（CAH）19例、慢性持续性肝炎（CPH）7例、肝硬化11例、“正常”携带者1例）和21例HBsAg阴性患者的肝脏及血清中的乙型肝炎病毒状态进行了特征分析。在19例HBeAg阳性患者（CAH 16例、CPH 1例、肝硬化2例）中发现肝脏中有游离型HBV-DNA，未检测到整合型HBV-DNA序列，且血清中伴有HBV-DNA。在13例HBsAg阳性HBeAg阴性患者（CAH 1例、CPH 5例、肝硬化7例）和1例HBsAg阴性患者中检测到整合序列。在1例HBsAg阳性HBeAg阴性CPH患者和4例HBsAg阳性肝硬化患者（2例HBeAg阳性、2例HBeAg阴性）中同时观察到游离型HBV-DNA和整合型HBV-DNA序列。HBcAg免疫荧光的存在与游离型HBV-DNA的存在情况吻合良好。建议对有游离型HBV-DNA的HBsAg阳性慢性肝炎患者进行抗病毒治疗，无论是否存在整合序列。由于肝脏中游离型HBV-DNA的存在并不总是伴有血清HBV-DNA的存在，因此抗病毒治疗患者的选择和评估程序应通过肝活检中HBV-DNA状态的特征分析加以扩展。
